As we age, postural sway tends to increase and balance control tends to decrease. Factors that contribute to this change include changes in:

Physiological and psychological function

Development of diseases

Use of drugs that affect the visual, vestibular and proprioceptive function

As a result, if some people slip, trip, or loose their balance it is less likely they will be able to recover equilibrium in time to prevent a fall.

Balance & Fall Prevention: Who Falls?

Strength and good nutrition are factors in balance & fall prevention

Frail older adults were matched for age, number of health problems and medications use. Those who fell compared to those who did not had:

Higher levels of nutritional risk

Poorer leg strength and balance

Poorer psychological well-being

Female gender

Disability of lower extremities

Hearing impairment

Sensory impairments are a substantial problem for older Americans: One out of six has impaired vision; one out of four has impaired hearing; one out of four has loss of feeling in the feet; and three out of four have abnormal postural balance testing. Not only are sensory impairments a problem, but they increase with age: Vision and hearing impairments each double, and loss of feeling in the feet increases by 40% in persons aged 80 years and over compared with persons aged 70-79 years.

Balance & Fall Prevention: The Visual System

Visual acuity is how sharp or clear your vision is.

Visual Acuity

Visual Acuity is the clarity or sharpness of vision. Cataracts are the most common cause of vision loss in people over age 40 and cataract surgery dramatically decreases the number of falls due to poor vision. Patients had a 78% decrease in the risk of falls the year after cataract surgery on one eye. But . . . the number of falls that required hospitalization doubled between first and second eye cataract surgeries. This emphasizes the need for timely provision of second eye surgery and appropriate refractive lenses management between surgeries. Poor visual acuity not only increases risk of fall but can result in dizziness. The percentage of patients who reported dizziness dropped from 52 percent to 38 percent six months after cataract surgery. But . . . the percentage of patients who reported falling after surgery dropped only slightly, from 23 percent to 20 percent. Researchers found a significant link between post-operative falls and the patient being switched to multi-focal lenses. “Unrelated to their cataract surgery status, people who wear multi-focal lenses have been shown to have increased fall rates,” says Dr. Lewerenz from the Lewerenz Medical Center.

Poor depth perception is a significant factor in falls.

Depth Perception

Bifocal/multifocal glasses distort depth perception while walking or climbing stairs. This is because the glasses are usually designed to be used looking down while reading. When the eyes are focused downward while walking looking through these same lenses, depth perception becomes greatly distorted. Other conditions that affect depth perception include Anisometropia – eyes with differing refractive errors, a cataract in only one eye, macular degeneration or gluacoma when one eye is frequently affected more than the other.

Contrast sensitivity

When contrast sensitivity is impaired, there is a limited ability to see well in low lighting or situations where there is little difference in colors and textures. Poor contrast sensitivity also can increase your risk of a fall if you fail to see that you need to step down from a curb onto similarly colored pavement. Low contrast sensitivity can occur with eye conditions such as cataracts, glaucoma or diabetic retinopathy.

Balance & Fall Prevention: The Sensory-Motor System

Good leg strength is an important factor in balance & fall prevention

Weakness

Muscle weakness, especially in the legs, is one of the most important risk factors. People with weak muscles are more likely to fall than are those who maintain their muscle strength, as well as their flexibility and endurance. Conditions that contribute to muscle weakness include:

If weakness is due to a medical condition, you may need help from physical therapy to develop an individualized treatment program to help you re-gain the strength you need to reduce your risk of falls.

Sensory Impairment

San Diego State University’s Daniel Goble, professor in the School of Exercise and Nutritional Sciences, studies “proprioception” — the ability to know where we are in space. And, as we age, proprioception decreases. “Imagine you are sitting down and you have your feet under a desk,” Goble explained. “Even without seeing your feet, you know where they are approximately and what direction they are pointing — that’s proprioception,” Goble said. “When proprioception begins to fail, we can’t sense those things and as a result we may misjudge or misstep. In the elderly, that misjudgment could result in a dangerous fall.” Regular physical activity seems to be a beneficial strategy to preserve proprioception and prevent falls among older subjects. Some studies have demonstrated that the regular physical activity can attenuate age-related decline in proprioception.

Balance & Fall Prevention: The Vestibular System

The inner-ear vestibular mechanism relates body position to gravity

The Purpose of the vestibular system is to determine head and body orientation in comparison to gravity. It is comprised of:

3 semicircular canals

5 sensory organs

Hair cells

Function: The semicircular canals contain fluid that moves in the opposite direction of the head movement. The fluid deflects hair cells that line the semicircular canals and fire the 8thcranial nerve (vestibular nerve). When the vestibular system is not working correctly, symptoms

Fluid moves through the semi-circular canals and trigger hair cells to give orientation

include:

Dizziness

Unsteadiness/Imbalance

Vertigo, Nausea

Visual Changes

Decreased concentration/memory

Muscle fatigue/aches

Headaches

Putting It All Together- The Brain Stem

Information from your vision, muscles, tendons, joints, and balance organs in your inner ear are all sent to the brain stem. The brain stem also gets information from other parts of the brain called the cerebellum and cerebral cortex, mostly about previous experiences that have affected your sense of balance. Your brain can control balance by using the information that is most important for a particular situation. For example, in the dark, when the information from your eyes is reduced or might not be accurate, your brain will use more information from your legs and your inner ear. If you are walking on a sandy beach during the day, the information coming from your legs and feet will be less reliable and your brain will use information from your visual and vestibular systems more. Once your brain stem sorts out all of this information, it sends messages to the eyes and other parts of your body to move in a way that will help you keep your balance and have clear vision while you are moving.

Treatment

Physical therapy can be a critical component to balance & fall prevention. A physical therapist can help to determine:

Which systems are working correctly and which are not

If information from these systems are being “put together” or “integrated” correctly.

How to improve these systems to keep your balance

Which exercises you can do to improve how your body uses all these systems together.

Environmental Modifications

85% of falls happen at home

Up to 85% of falls occur in the home and simple home modifications can go a long way in fall prevention. Most falls occur in the bedroom, bathroom, kitchen and stairs. Risk factors include: low bed heights, poorly equipped chairs and toilets, low-lying objects or floor coverings, poorly visualized door thresholds, slippery (highly polished) floor surfaces or wet floor surfaces, unsecured rugs, and poorly lit walkways and stairs.

To be effective, environment modification must accommodate balance problems and be aesthetically pleasing. By watching a person maneuver about his or her living environment, a therapist can determine which areas increase risk. The therapist will observe the client:

Walking over all the different ground surfaces in the environment.

Transferring from beds, chairs, toilet, in and out of the bathtub or shower, in and out of the car.

Reaching up and bending down to retrieve objects from low and high surfaces

Navigating stairs.

Other factors to be evaluated include:

Footwear:

Footwear that provides stability and a non-skid surface is important for good balance. Range of motion and/or strength limits often cause difficulty bending down to apply footwear. Because of this, people often wear loose fitting slippers. Elastic shoe laces, long-handled shoehorns, reachers, shoes with Velcro fasteners, or orthopedic shoes may be necessary to decrease the risk of falls.

Flooring:

Thick carpets should be replaced with ones made of uncut low pile. Patterned carpets should be avoided. Area rugs should have nonskid backings. Throw rugs should be removed.

Good lighting is important to balance & fall prevention

Lighting:

Getting up at night in a darkened bedroom reduces the visual function component of the balance system. Night lights, leaving a bathroom light on, and using light switch plates that contrast the color of the wall and can be illuminated assist with night visibility. Persons with cataracts experience difficulty with glare, are sensitive to bright lights, and may suffer further visual impairment if lighting is too bright. Light sources should be positioned to eliminate glare and shadows.

Good contrast on stair edges are important for balance & fall prevention

Stairs:

Good lighting is essential in stairways. Patterned carpets or floor coverings disguise step edges and must be removed. Step edges can be enhanced by painting or taping the edges in a contrasting color. Handrail should extend at least 12 inches beyond the end of the stairway and should be a contrasting color to the wall.

Bathrooms: Toilets

Walkers typically don’t fit in bathrooms because of space limitations and balance is assisted by clutching doorknobs, bare walls, sinks and towel bars.

Grab bars provide necessary support for balance & fall prevention

These structures are either not stable or not designed to support the weight of someone. Grab bars provide stability and are designed to support a person’s body weight if installed properly. Toilet grab bars that attach to the toilet allow a person to exert maximum force straight downward with the hands and arms which provides support during transfers. High-rise toilet seats reduce the amount of leg strength required to lower and raise oneself from the toilet and the amount of forward bending required to maintain control during sit to stand.

Bathrooms: Showers

Slip resistant bath rugs or mats can help reduce slippage on wet surfaces. Soaps and shampoos should be placed to avoid reaching overhead or stooping. Grab bars in the shower or bath provide support during entrance and exit. Tub transfer benches, tub seats or shower seats along with a flexible handheld shower hose enable bathing to be completed in sitting.

Chair risers compensate for limits in leg strength

Bedrooms:

Beds height should not be too high or too low. Beds should be approximately 18 inches in height, measured from the floor to the top of the mattress. Bed leg risers can be purchased to increase the height of a bed that is too low.

Mattresses that are too soft make pushing up into sitting difficult. A firm mattress enables support when pushing up. Bed rails may be added to a bed to provide extra support. They must be securely fastened to do so.

Kitchen

Chairs that are low or without armrests are difficult to transfer on and off of. Chairs should have armrests approximately 7 inches above the seat and extend at least 1 inch beyond the seat edge for maximum leverage. Avoid cross rails on chair legs, which prevent the person’s legs from sliding underneath the seat to assist in rising. Chair legs should not slide when leaned on. Chairs should be stable enough to support a person’s weight when leaned on. Drop-leaf and pedestal-type tables tend to tip over when weight is applied to the edge and should be avoided.

Kitchen carts allow safe transportation of objects

Kitchen carts should can be used for transferring items such as food, utensils, and dishes from one part of the room to the next. Frequently used items should be arranged to they are located between a person’s hip and eye level to avoid reaching up or bending down.

Keep Active!

Keeping active is one of the most important factors to fall prevention. By being mindful of factors that put you at risk for falling and taking preventative measures will keep you on the road of independence!

Keeping active is one of the best things you can do for balance & fall prevention

At our May meeting, Dr. Laganke suggested adding physical therapy when starting Ampyra may enhance the gains you make in motor skills and walking. If you would like to schedule an appointment to see if this would be helpful for you, call us at 256-509-4398.

Physical Therapy Enhances Benefit of Ampyra

Ampyra is a medication used to improve walking in patients with multiple sclerosis (MS). Studies show patient who take Ampyra had an increase in walking speed in clinical trials. Exactly how it works is not known. It is thought to increase nerve function. Dr. Chris Laganke spoke at the Huntsville MS Awareness Group and explained how Ampyra is thought to work and how to decide if you are a candidate for Ampyra. He suggested attending physical therapy when starting Ampyra may enhance the gains made in motor skills and walking.

The goal of physical therapy is to maintain physical functioning, safety, quality of life, and independence. Your physical therapist (PT) will use a range of interventions to help you achieve these goals, including:

Education about physical symptoms of MS and what you can do to alleviate these symptoms

An individualized exercise program to address symptoms and maximize health and physical function

Aids and adaptive equipment for home, office, and automobile to enhance mobility and functionality

Therapy Achievements is a Rehabilitation Center that provides out-patient Physical Therapy, Occupational Therapy and Speech Therapy. We have programs for Balance and Movement, Speech and Swallowing, Swelling from Lymphedema and Edema, Driving Rehabilitation and Functional Living Skills for visual and cognitive re-training. We help people with Brain Injury, Stroke, Multiple Sclerosis, Parkinson’s Disease, Lymphedema, Head and Neck Cancer, and other disorders that interfere with mobility and function. We offer VitalStim Technology, Saebo Technology, LSVT LOUD Treatment, LSVT BIG Treatment, and Neurodevelopmental Treatment.

Thanks to all the volunteers who helped make the Ambucs Therapy Bike Build a huge success! A record number of bikes were assembled and distributed to disabled children and adults. These bikes give people who are unable to operate a traditional bike the fun and freedom of riding their own bike. As therapists, we know how important mobility is to staying healthy both physically and emotionally and Therapy Achievements is proud to assist this terrific organization.

Semper Fi VolunteersTammy and Willard

Ambucs Therapy Bikes is one of the core charities of the Huntsville Semper Fi Riders organization. Semper Fi Riders is a group of Marines who love motorcycles and who’s mission is to support worthwhile causes involving America’s veterans and their families by giving of their time and sponsoring charitable events. They not only purchase the bikes but assembly and distribute them as well. Ooh Rah!

Pain after Breast Cancer: CostocondritisAsk about pain after breast cancer and you often get a vague answer about pain being normal part of recovery and a recommendation to give it more time. That may be true for many women, but not for all. “Not long after finishing radiation therapy, I started getting this pain in my ribs and chest. It is a stabbing and burning pain. The pain only lasts for half a minute when I give it a rub thank goodness!” says one member of the Breast Cancer Network of Australia .
“An ultrasound found the cartilage between my rib bones is lumpy and close to under the skin, which the oncologist says isn’t anything to worry about. It has been there since I had the mastectomy operation early 2009. I asked my surgeon about it and he said it has probably been there forever but now my breast is gone I can feel it. I do worry because it is below the area where my multifocal tumors were situated.” Because she continued to ask, she discovered the source of her pain was actually costrocondrities.

Costocondritis is inflammation of the cartilage that joins the ribs to the breastbone (called costal cartilages). Also known as anterior chest wall pain, costosternal syndrome or parasternal chondrodynia, it causes pain in the chest wall around the breastbone (or sternum) and sometimes is severe.
Costochondritis is a common problem in women who have been affected by breast cancer and acts up in a similar way to arthritis. The pain may be mild to severe with tenderness over the anterior chest and may radiate to the back, shoulders, stomach or arms. Pain is often aggravated with coughing, lifting, straining, sneezing and deep breathing. Pain can be constant or intermittent and can last for several days to multiple months/years.

“Apparently once you get it, it can flare up at any time and you have to be cautious with over-working your arms with things like lifting, painting and sweeping. Sometimes the pain can extend to the shoulder or arm on the involved side.”

When costochondritis is accompanied by swelling of the areas surrounding the cartilage, the condition is called Tietze syndrome which causes localized musculoskeletal pain. In Tietze syndrome, the swollen area of the inflamed cartilage may be tender to the touch, and the skin overlying the cartilage may be reddened.

Physical Therapy for CostochondritisOften times treatments that improve arthritis symptoms may improve symptoms of costochondritis as well. Treatment options typically include a combination of rest, ice and analgesics, anti-inflammatory medications (Advil, Motrin, Aleve), thoracic mobilization, breathing facilitation techniques and stretches. In some cases of severe pain, cortisone injections or surgery have been utilized- with mixed results. Stretching exercises have shown to be beneficial. Linda Miller from the “Ask the Expert” forum of breastcancer.org states, “I can’t overemphasize the importance of continuing stretching long after you’ve had your breast cancer surgery, especially with mastectomy. The tendency will always be for that skin and pectoral muscle to tighten up, and so stretching 2 to 3 times a week may help relieve some of those long-term chronic symptoms. “

At Therapy Achievements, we specialize in treating pain and mobility limits associated with treatment of cancer. Our therapists have had advanced training in manual therapy techniques designed to reduce pain and swelling and enhance flexibility and movement. We are a Rehabilitation Center that provides Physical, Occupational and Speech Therapy for Balance and Movement, Speech and Swallowing, Swelling from Lymphedema and Edema, Driving Rehabilitation and Functional Living Skills for visual and cognitive re-training. In addition to treating patients with cancer, we help people with Brain Injury, Stroke, Multiple Sclerosis, Parkinson’s Disease, Lymphedema, Vertigo and Dizziness, and other disorders that interfere with mobility and function. We offer VitalStim Technology, Saebo Technology, LSVT LOUD Treatment, LSVT BIG Treatment, and Neuro-Developmental Treatment.

Cathy Craver, physical therapist, teaches wheelchair fitting to other therapists with a goal of optimizing function for patients. Cathy works at Spain Rehabilitation Center and recently presented “Seating and Wheeled Mobility: Where Science and Art Meet” to therapists in North Alabama. Cathy has a passion for helping others and has been a physical therapist at Spain Rehabilitation Center for more than 11 years. “I decided I wanted to work with people who have regular problems and who want to live a regular life. I wanted to find a way to help people make the most of their life situation given their disability. Since then it’s been a creative challenge. How do you help people make the most of what they have so they can live the life they have left to live? That drives me every day.” Wheelchair evaluation and fittings are one of the ways she does that.
People who use wheelchairs know the correct wheelchair fit is essential for optimal function. Wheelchairs come in all shapes and sizes and people who have issues with limits in mobility often cannot shift, move or maintain upright sitting without the supports provided by their chairs. “Your wheelchair is an important part of your life, so you want to make sure you end up with the right wheelchair that fits your body, preferences, activities and lifestyle” says The Model Systems Knowledge Translation Center (MSKTC), an advocacy group for individuals with traumatic brain injury (TBI), spinal cord injury (SCI), and burn injury. “With new types of wheelchairs and components coming on the market all the time, the days of “one size fits all” are long gone.” Some of MSKTC recommends you consider include:The Clinic: Selecting the right clinic is a critical first step. The clinic you select should have a process and the key players in place to assist you with making the right choice.The Team: Your team should include experienced rehabilitation professionals including:
• A medical doctor who understands your overall health situation. The doctor is the one who writes the prescription needed for your insurance to pay for the wheelchair and has ultimate responsibility for determination of medical necessity.
• An Occupational or physical therapist who is experienced in wheelchair evaluation and training.
• A Qualified wheelchair supplier who works with the therapy and medical team to trial, order and maintain equipment.Certification: Many occupational and physical therapists and wheelchair suppliers will have Assistive Technology Practitioner (ATP) certification from RESNA (Rehabilitation Engineering and Assistive Technology Society of North America) indicating they have passed a national examination and credentials check in their specialty. If Medicare is the payer, they require the wheelchair vendor to have at least one ATP-credentialed specialist.

Karen Allen Hislop is the therapist who does wheelchair evaluations and fittings at Therapy Achievements. She is ATP Seating Specialist certified with RESNA and has been doing wheelchair evaluations and fittings for over 20 years. She works with a number of doctors and wheelchair suppliers to ensure patients get the correct wheelchair fit for optimal function.

Therapy Achievements is a Rehabilitation Center that provides Physical, Occupational and Speech Therapy for Balance and Movement, Speech and Swallowing, Swelling from Lymphedema and Edema, Driving Rehabilitation and Functional Living Skills for visual and cognitive re-training. We help people with Brain Injury, Stroke, Multiple Sclerosis, Parkinson’s Disease, Lymphedema, Head and Neck Cancer, Vertigo and Dizziness, and other disorders that interfere with mobility and function. We offer VitalStim Technology, Saebo Technology,LSVT LOUD Treatment, LSVT BIG Treatment, and Neuro-Developmental Treatment.

July is Arthritis Awareness Month and physical therapy helps manage arthritis pain and flexibility. How can physical therapists help? Physical therapists can provide you with specific exercises designed to preserve the mobility, strength, and use of your joints. Physical therapists can teach you the proper body mechanics to move from one position to another and the proper mechanics during the performance of household activities. They can teach you proper posture, such as while sitting, to protect the integrity of the joints. They can also educate you on the use of walking aids such as crutches, a walker, or a cane when needed. Your physical therapist will tailor a program to your specific needs, whether your arthritic problems are widespread or confined to one joint or body area. In addition to consulting with physical therapy, there are things you can do to manage your pain an flexibility:

Keep exercising.

As it gets hot outside, you may not be able to get the exercise you need from activities like walking or gardening. However, it is important to keep exercising a little every day. There are many strengthening and range of movement exercises you can do indoors and you should ask your physical therapist about these. Strengthening exercises can build the muscles around a weak joint to help keep it stable and range-of-movement exercises can keep arthritic joints mobile.

Lose weight for the sake of your knees.

Every time you take a step the pressure across your knees is three to four times your body weight. We all know it is hard to lose weight, but even losing three pounds of weight can take about nine to 12 pounds of pressure off your knees when you walk.

Keep Hydrated.

The amount of water you drink in a day can affect your joint health. Staying properly hydrated throughout the day helps you maintain an adequate blood volume so that nutrients can move through your blood and into your joints. If you think of your joints like a sponge, imagine how much more easily two wet sponges can move against one another than two dry, hard sponges. Water also allows waste products to move out of the joints.

Keep safe.

Your arthritis may predispose you to falls and broken bones so be extra careful when walking over grass or wet surfaces. Avoid flip-flops or sandals that don’t give good support and wear shoes with a good grip. Walk slowly, taking small and steady steps.

Get an adequate supply of calcium and vitamin D.

Therapy Achievements’ therapists have over 20 years of experience and advanced training in treatment of balance and movement disorders. We have physical, occupational and speech therapy services and would welcome the opportunity to help you optimize your fitness program and optimize how you with arthritis.

We need calcium and vitamin D for healthy bones. To make vitamin D we need sunshine so take advantage of summer’s warm sunny days and get some sun. If you are concerned you are not getting enough vitamin D, talk to you doctor about calcium and vitamin D supplements that you can take by mouth.

Therapy Achievements is a Rehabilitation Center that provides Physical, Occupational and Speech Therapy for Balance and Movement, Speech and Swallowing, Swelling from Lymphedema and Edema, Driving Rehabilitation and Functional Living Skills for visual and cognitive re-training. We help people with Brain Injury, Stroke, Multiple Sclerosis, Parkinson’s Disease, Lymphedema, Head and Neck Cancer, Vertigo and Dizziness, and other disorders that interfere with mobility and function. We offer VitalStim Technology, Saebo Technology, LSVT LOUD Treatment, LSVT BIG Treatment, and Neuro-Developmental Treatment.

The Bioness Foot Drop System is designed to help people walk more naturally, with increased speed and improved balance. The Bioness advanced technology delivers programmed, low-level electrical stimulation to activate nerves and muscles that lift the foot, giving you the mobility to step back into life. The system’s gait sensor adapts to changes in walking speed and terrain, allowing you to walk easily on stairs, grass and carpet. Comfortably worn under most clothing, the Bioness Foot Drop System’s unique design can help you eliminate the need for a rigid ankle-foot orthosis (AFO), or braces, and may reduce the risk of falls and injuries.

Therapy Achievements is having a Bioness Clinic on Tuesday April 28, 2015. To see if Bioness system will help you, sign up for a free trial at Bioness 800-211-9136.

Therapy Achievements is a Rehabilitation Center that provides Physical, Occupational and Speech Therapy for Balance and Movement, Speech and Swallowing, Swelling from Lymphedema and Edema, Driving Rehabilitation and Functional Living Skills for visual and cognitive re-training. We help people with Brain Injury, Stroke, Multiple Sclerosis, Parkinson’s Disease, Lymphedema, Head and Neck Cancer, Vertigo and Dizziness, and other disorders that interfere with mobility and function. We offer VitalStim Technology, Saebo Technology,LSVT LOUD Treatment, LSVT BIG Treatment, and Neuro-Developmental Treatment.

Physical therapy can ease many of your Multiple Sclerosis symptoms and help you get around better. Physical therapy for Multiple Sclerosis in Huntsville, AL is provided at Therapy Achievements. Seeing a physical therapist can help you with:

Balance problems

Clumsiness and poor coordination

Fatigue & Strategies to save energy

Pain

Weakness

Fitness

On your first visit, your therapist will evaluate your strength, range of motion, coordination, balance and ability to complete functional activities. Based on your results, she will develop an individualized treatment plan of exercises, activities and modalities to work on in therapy as well as an exercise program you can do at home. Regular exercise helps with all types of MS at all levels of ability and your therapist will work with you to create the right fitness program that matches your strength and goals. She will also help you learn:

How to work around fatigue and heat sensitivity

Stretches to prevent or ease muscle spasms

Moves to keep muscles strong

Range-of-motion exercises

Tips to prevent falls

How to use canes, crutches, scooters, wheelchairs, or other aids, if necessary

Physical Therapy at Therapy Achievements Cathy McNeely is one of the physical therapists at Therapy Achievements and has many years of experience working with people with neurological and orthopedic disorders. She is certified in the LSVT BIG program and has taken advanced training in dizziness and vertigo. Physical therapy services are typically covered by health insurance and Therapy Achievements is an in-network provider for most insurances.

Therapy Achievements is a Rehabilitation Center that provides Physical, Occupational and Speech Therapy for Balance and Movement, Speech and Swallowing, Swelling from Lymphedema and Edema, Driving Rehabilitation and Functional Living Skills for visual and cognitive re-training. We help people with Brain Injury, Stroke, Multiple Sclerosis, Parkinson’s Disease, Lymphedema, Head and Neck Cancer, Vertigo and Dizziness, and other disorders that interfere with mobility and function. We offer VitalStim Technology, Saebo Technology, LSVT LOUD Treatment, LSVT BIG Treatment, and Neuro-Developmental Treatment.

Mary Beth has multiple sclerosis and is working on better posture with Cathy in physical therapy. But people with MS are not the only ones who have trouble with their posture. Long work days, hours spent sitting at a computer, and increased amount of time spent texting contribute to poor posture for many people. Here’s 5 tips on how to have better posture:

Don’t just sit there, get up and move! Avoid slumping and other poor postures by changing positions frequently. Poor posture puts extra pressure on your neck and back and re-positioning helps realign your joints and reduces stress. Take a break from sitting every half hour for two minutes in order to stretch, stand, or walk.

Wear supportive footwear. Wearing high-heeled shoes causes the body’s center of gravity to shift forward. To keep your balance, you must compensate the alignment of the entire body in a way that negatively affects your back and posture. Wearing supportive shoes enables the body to align correctly and improves posture and comfort.

Exercise to prevent injury and promote good posture. Keep the muscles that surround your back strong to promote good posture and prevent injury. Keeping your “core” strong will enable your to sit, walk, lift and carry with good alignment and reduce the stress on your joints.

Tuck your chin. Be aware of the tendency to let your head drift forward. This puts stress on your neck and shoulders and is the leading cause of upper back pain. To check your head position, stand with your heels, hips, shoulders and head against the wall. Now tuck your chin down toward your sternum, keeping your head on the wall. Feel the stretch? That’s a clue that your head is not used to being in correct alignment with your spine.

Stay flexible. Tight muscles put stress on your joints and make it difficult to keep your joints in good alignment. Keep flexible by doing yoga, tia chi or other exercise that stretches your muscles.